Pathologic fracture
Encyclopedia
A pathologic fracture is a broken bone caused by disease leading to weakness of the bone. This process is most commonly due to osteoporosis
, but may also be due to other pathologies such as: cancer
, infection
, inherited bone disorders,or a bone cyst
. Only a small number of conditions are commonly responsible for pathological fractures, including osteoporosis
, osteomalacia
, paget's disease
, osteitis, osteogenesis imperfecta
, benign bone tumours and cysts, secondary malignant bone tumours and primary malignant bone tumours.
Fragility fracture is a type of pathologic fracture that occurs as result of normal activities, such as a fall from standing height or less. There are three fracture sites said to be typical of fragility fractures: vertebral fractures, fractures of the neck of the femur, and Colles fracture of the wrist. This definition arises because a normal human being ought to be able to fall from standing height without breaking any bones, and a fracture therefore suggests weakness of the skeleton.
Pathological fractures present as a chalkstick fracture
in long bones, and appear as a transverse fractures nearly 90 degrees to the long axis of the bone. In a pathological compression fracture
of a spinal vertebra fractures will commonly appear to collapse the entire body of vertebra
.
In circumstances where other pathologies are excluded (for example, cancer
), a pathologic fracture is diagnostic of osteoporosis
irrespective of bone mineral density.
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
, but may also be due to other pathologies such as: cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
, infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
, inherited bone disorders,or a bone cyst
Bone cyst
A bone cyst or geode is a type of cyst that can present itself in the jaw, or on other locations in the body.Types include:* Simple bone cyst* Aneurysmal bone cyst* Traumatic bone cyst- History :...
. Only a small number of conditions are commonly responsible for pathological fractures, including osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
, osteomalacia
Osteomalacia
Osteomalacia is the softening of the bones caused by defective bone mineralization secondary to inadequate amounts of available phosphorus and calcium, or because of overactive resorption of calcium from the bone as a result of hyperparathyroidism...
, paget's disease
Paget's disease
Sir James Paget, a surgeon and pathologist, described several diseases, including:* Paget's disease of bone * Paget's disease of the breast* Paget-Schroetter disease* Extramammary Paget's disease...
, osteitis, osteogenesis imperfecta
Osteogenesis imperfecta
Osteogenesis imperfecta is a genetic bone disorder. People with OI are born with defective connective tissue, or without the ability to make it, usually because of a deficiency of Type-I collagen...
, benign bone tumours and cysts, secondary malignant bone tumours and primary malignant bone tumours.
Fragility fracture is a type of pathologic fracture that occurs as result of normal activities, such as a fall from standing height or less. There are three fracture sites said to be typical of fragility fractures: vertebral fractures, fractures of the neck of the femur, and Colles fracture of the wrist. This definition arises because a normal human being ought to be able to fall from standing height without breaking any bones, and a fracture therefore suggests weakness of the skeleton.
Pathological fractures present as a chalkstick fracture
Chalkstick fracture
Chalkstick fractures are fractures, typically of long bones, in which the fracture is transverse to the long axis of the bone, like a broken stick of chalk. A healthy long bone typically breaks like a hard woody stick as the collagen in the matrix adds remarkable flexibility to the mineral and the...
in long bones, and appear as a transverse fractures nearly 90 degrees to the long axis of the bone. In a pathological compression fracture
Compression fracture
A compression fracture is a collapse of a vertebra. It may be due to trauma or due to a weakened vertebra. This weakening is seen patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors, or infection. In healthy patients it is most often seen in...
of a spinal vertebra fractures will commonly appear to collapse the entire body of vertebra
Body of vertebra
The body is the largest part of a vertebra, and is more or less cylindrical in shape. For vertebrates other than humans, this structure is usually called a centrum....
.
In circumstances where other pathologies are excluded (for example, cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
), a pathologic fracture is diagnostic of osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
irrespective of bone mineral density.
External links
- Pathologic fracture entry in the public domain NCI Dictionary of Cancer Terms